Managed Care

 

More pressure on Part D plans

MANAGED CARE December 2011. © MediMedia USA
News & Commentary

More pressure on Part D plans

MANAGED CARE December 2011. ©MediMedia USA

Greater emphasis on quality might lead to the dropping of some Medicare Advantage drug plans from the program. The Centers for Medicare & Medicaid Services changed the way it evaluated Part D plans last month, and 28 percent of drug plans that will be available to Medicare enrollees in 2012 get fewer than three stars out of a possible five (for excellent). There are about 1,500 stand-alone Part D plans in the country. CMS notified the low performers that unless there is improvement, they could find themselves shut out of the program, thanks to a new rule that allows the agency to expel drug plans with three or fewer stars for three consecutive years.

Percentage of Part D plans with fewer than three stars, by state

Source: Centers for Medicare & Medicaid Services

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4th Partnering With ACOs Summit Los Angeles, CA October 27–28, 2014
PCMH & Shared Savings ACO Leadership Summit Nashville, TN November 3–4, 2014
2014 Annual HEDIS® and Star Ratings Symposium Nashville, TN November 3–4, 2014
Medicare Risk Adjustment, Revenue Management, & Star Ratings Fort Lauderdale, FL November 12–14, 2014
World Orphan Drug Congress Europe 2014 Brussels, Belgium November 12–14, 2014
Healthcare Chief Medical Officer Forum Alexandria, VA November 13–14, 2014
Home Care Leadership Summit Atlanta, GA November 17–18, 2014
HealthIMPACT Southeast Tampa, FL January 23, 2015